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BACKGROUND: The Self-Assessment Manikin (SAM), a pictorial scale for the measurement of pleasure and arousal dimensions of emotions, is one of the most applied tools in the emotion research field. OBJECTIVE: We present a detailed description of a remote method to collect affective ratings in response to pictures by using the SAM scale. METHODS: To empirically validate our remote method, we conducted a study using a digitized version of the SAM scale and delivered online didactic instructions that followed the normative rating procedure for the International Affective Picture System (IAPS) to the participants. We presented 70 pictures from the IAPS and an additional set of 22 food pictures to the participants. RESULTS: We found strong correlations between the ratings of IAPS pictures obtained in our sample and those reported by North American and Brazilian participants in previous in-person studies that applied the same pictures and methodology. We were also able to obtain an additional standardized set of food pictures. CONCLUSION: The protocols described here may be useful for researchers interested in collecting remotely valid and reliable affecting ratings.
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Abstract: Introduction: Simulation-based training has become a comprehensive practice to improve skill levels in procedures such as intubation. Clinicians performing endotracheal intubation must be competent to perform this technical skill safely. Objective: Determine the success of the use of mobile remote technology in learning intubation laryngoscopy during training in the hospital. Material and methods: Experimental, cross-sectional, comparative, non-blind, randomized study which was made up of 117 students of the Bachelor of Medicine degree at the Autonomous University of Nuevo Leon. Results: Group A with conventional laryngoscopy achieved successful intubation in an average of 106.86 ± 84.87 seconds, group B in 62.90 ± 65.81 and when crossing the groups in the technique, the time of video laryngoscopy was taken, where group A reported an average time of 64.25 ± 34.23, while the time recorded in group B was 84.25 ± 55.67 seconds. Conclusion: The use of mobile remote technology is effective for the preparation of doctors and future doctors when performing an orotracheal intubation. Videolaryngoscopy was significant to conventional laryngoscopy when performed in inexperienced personnel.
Resumen: Introducción: El entrenamiento basado en simulación se ha convertido en una práctica integral para mejorar los niveles de habilidad en procedimientos como la intubación. Los médicos que realizan intubación endotraqueal deben ser competentes. Objetivo: Determinar el éxito del uso de la tecnología remota móvil en el aprendizaje de la laringoscopía de intubación durante la formación en el hospital. Material y métodos: Estudio experimental, transversal, comparativo, no ciego, aleatorizado que contó con 117 estudiantes de la Licenciatura en Medicina de la Universidad Autónoma de Nuevo León. Resultados: El grupo A con laringoscopía convencional logró intubación exitosa en un promedio de 106.86 ± 84.87 segundos, el grupo B en 62.90 ± 65.81 y al cruzar los grupos en la técnica se tomó el tiempo de videolaringoscopía, donde el grupo A reportó un tiempo promedio de 64.25 ± 34.23, mientras que el tiempo registrado en el grupo B fue de 84.25 ± 55.67 segundos. Conclusión: El uso de tecnología remota móvil es efectivo para la preparación de médicos y futuros médicos a la hora de realizar una intubación orotraqueal. La videolaringoscopía fue significativa para la laringoscopía convencional cuando se realizó en personal sin experiencia.
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Most everyday actions engender interactions with meaningful emotionally-laden stimuli. This study aimed to select pictures of objects as emotional stimulus of affordance to be grasped. The participant's depression trait was also assessed to examine its effect on the judgment of these pictures, and time spent in the classification was computed. Sixty-three participants joined this study. Self-Assessment-Manikin scale was used to classify pictures of the objects, and Beck Depression Inventory was applied to distribute the sample according depression trait. Cluster analysis was used in the classification of 123 objects based on valence and arousal values. Cluster results returned 102 classified pictures in three categories: pleasant (21), neutral (48) and unpleasant (33). Where cluster analysis did not agree, the picture was excluded and not used any further (21). Pleasant pictures presented the highest valence values and unpleasant pictures the lowest, and both categories returned the highest arousal level. In the middle of the valence range, the neutral category evoked the lowest arousal levels. Participants were slower to classify unpleasant pictures in valence sub-scale and faster to classify neutral pictures in arousal one. There was no effect of depression in the response time needed to score the pictures. Thus, agreement of high-performance soft clustering algorithms emerged as a good tool to classify pictures representing objects based on valence and arousal dimensions. Depression trait does not significantly affect the accuracy or time-order of emotional classification. Finally, we presented a set of emotional stimuli that can be employed to examine distinct aspects of emotion over physiology and behavior.
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Formación de Concepto/fisiología , Depresión/fisiopatología , Trastorno Depresivo/fisiopatología , Emociones/fisiología , Reconocimiento Visual de Modelos/fisiología , Adulto , Análisis por Conglomerados , Femenino , Humanos , Masculino , Placer/fisiología , Adulto JovenRESUMEN
OBJECTIVE: The present study aimed to (i) assess the appetitive drives evoked by the visual cues of ultra-processed food and drink products and (ii) investigate whether text warnings reduce appetitive drives and consumers' reported intentions to eat or drink ultra-processed products. DESIGN: In Study I, a well-established psychometric tool was applied to estimate the appetitive drives associated with ultra-processed products using sixty-four image representations. Sixteen product types with four exemplars of a given product were included. Pictures from the International Affective Picture System (IAPS) served as controls. The two exemplars of each product type rated as more appetitive were selected for investigation in the second study. Study II assessed the impact of textual warnings on the appetitive drive towards these thirty-two exemplars. Each participant was exposed to two picture exemplars of the same product type preceded by a text warning or a control text. After viewing each displayed picture, the participants reported their emotional reactions and their intention to consume the product. SETTING: Controlled classroom experiments SUBJECTS: Undergraduate students (Study I: n 215, 135 women; Study II: n 98, 52 women). RESULTS: In Study I, the pictures of ultra-processed products prompted an appetitive motivation associated with the products' nutritional content. In Study II, text warnings were effective in reducing the intention to consume and the appetitive drive evoked by ultra-processed products. CONCLUSIONS: This research provides initial evidence favouring the use of text warnings as a public policy tool to curb the powerful influence of highly appetitive ultra-processed food cues.
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Apetito , Señales (Psicología) , Comida Rápida , Conducta Alimentaria/psicología , Promoción de la Salud/métodos , Intención , Envío de Mensajes de Texto , Adolescente , Adulto , Comunicación , Emociones , Femenino , Alimentos , Manipulación de Alimentos , Humanos , Masculino , Motivación , Valor Nutritivo , Psicometría , Estudiantes , Adulto JovenRESUMEN
Abstract Objective The angle of the C-MAC D-Blade® videolaryngoscope, which is used for difficult airway interventions, is not compatible with routinely used endotracheal tubes. Methods A prospective randomized crossover study was performed comparing five intubation methods for use with standardized airways, including using different stylets or no stylet: Group HS, hockey-stick stylet; Group DS, D-blade type stylet; Group CS, CoPilot® videolaryngoscope rigid stylet®; Group GEB, gum elastic bougie; and Group NS, no stylet. A manikin was used to simulate difficult intubation with a Storz C-MAC D-Blade® videolaryngoscope. The duration of each intubation stage was evaluated. Results Participants in this study (33 anesthesiology residents and 20 anesthesiology experts) completed a total of 265 intubations. The number of attempts made using no stylet was significantly greater than those made for the other groups (p < 0.05 for group NS- group GEB, group NS- group DS, group NS- group CS and group NS- group HS). The duration to pass the vocal cords significantly differed among all groups (p < 0.001). The total intubation duration was shortest when using D-blade stylet, CoPilot stylet and hockey stick stylet. Although no difference was observed between stylet groups, a significant difference was found between each of these three and no stylet and gum elastic bougie (p < 0.05 and p < 0.001, respectively). Conclusion Use of the correct stylet leads to a more efficient use of the Storz C-MAC D-Blade®. In our study, the use of the D-blade stylet, the CoPilot stylet and the hockey stick stylet provided quicker intubation, allowed easier passage of the vocal cords, and decreased the total intubation duration. To confirm the findings of our study, randomized controlled human studies are needed.
Resumo Objetivo O ângulo do videolaringoscópio C-D-MAC Blade®, usado para intervenções em via aérea difícil, não é compatível com os tubos endotraqueais rotineiramente usados. Métodos Um estudo prospectivo, randômico e cruzado foi conduzido para comparar cinco métodos de intubação em modelo de via aérea, com o uso de diferentes estiletes em cinco grupos: taco de Hockey; D-blade; CoPilot VL® rígido; Gum Elastic Bougie e controle (sem estilete). Um manequim foi utilizado para simular intubação difícil com o laringoscópio Storz C-MAC D-Blade®. Foi avaliada a duração de cada fase de intubação. Resultados Os participantes deste estudo (33 residentes de anestesiologia e 20 especialistas em anestesiologia) concluíram 265 intubações no total. O número de tentativas realizadas sem estilete foi significativamente maior que o dos outros grupos (p < 0,05 para SE-GEB, SE-DB, SE-CP e SE-HS). O tempo para passar pelas cordas vocais foi significativamente diferente entre todos os grupos (p < 0,001). O tempo total de intubação foi menor com o uso de D-blade, CoPilot VL® rígido e taco de Hockey. Embora não tenha havido diferença entre D-blade, CoPilot VL® rígido e taco de Hockey, uma diferença significativa foi observada entre cada um desses três e os grupos sem estilete e Gum Elastic Bougie (p < 0,05 e p < 0,001, respectivamente). Conclusão A escolha do estilete certo leva ao uso mais eficiente do videolaringoscópio Storz C-MAC D-Blade®. Em nosso estudo, o uso do D-blade, CoPilot VL® rígido e taco de Hockey proporcionou intubação mais rápida, facilitou a passagem pelas cordas vocais e diminuiu o tempo total de intubação. Para confirmar os resultados de nosso estudo, estudos controlados e randômicos com humanos são necessários.
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Humanos , Masculino , Femenino , Adulto , Laringoscopios , Intubación Intratraqueal/instrumentación , Grabación en Video , Estudios Prospectivos , Estudios Cruzados , Diseño de Equipo , Anestesiología/educación , Persona de Mediana EdadRESUMEN
OBJECTIVE: The angle of the C-MAC D-Blade® videolaryngoscope, which is used for difficult airway interventions, is not compatible with routinely used endotracheal tubes. METHODS: A prospective randomized crossover study was performed comparing five intubation methods for use with standardized airways, including using different stylets or no stylet: Group HS, hockey-stick stylet; Group DS, D-blade type stylet; Group CS, CoPilot® videolaryngoscope rigid stylet®; Group GEB, gum elastic bougie; and Group NS, no stylet. A manikin was used to simulate difficult intubation with a Storz C-MAC D-Blade® videolaryngoscope. The duration of each intubation stage was evaluated. RESULTS: Participants in this study (33 anesthesiology residents and 20 anesthesiology experts) completed a total of 265 intubations. The number of attempts made using no stylet was significantly greater than those made for the other groups (p<0.05 for group NS- group GEB, group NS- group DS, group NS- group CS and group NS- group HS). The duration to pass the vocal cords significantly differed among all groups (p<0.001). The total intubation duration was shortest when using D-blade stylet, CoPilot stylet and hockey stick stylet. Although no difference was observed between stylet groups, a significant difference was found between each of these three and no stylet and gum elastic bougie (p<0.05 and p<0.001, respectively). CONCLUSION: Use of the correct stylet leads to a more efficient use of the Storz C-MAC D-Blade®. In our study, the use of the D-blade stylet, the CoPilot stylet and the hockey stick stylet provided quicker intubation, allowed easier passage of the vocal cords, and decreased the total intubation duration. To confirm the findings of our study, randomized controlled human studies are needed.
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Intubación Intratraqueal/instrumentación , Laringoscopios , Adulto , Anestesiología/educación , Estudios Cruzados , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Grabación en VideoRESUMEN
ABSTRACT OBJECTIVE: Several devices can aid nasotracheal intubation when managing difficult airways. The McGrath MAC and Airtraq NT were compared with a Macintosh laryngoscope when studying the performance of anaesthetists with different levels of experience, in a manikin model of easy or difficult airway scenarios. METHODS: Sixty-three anaesthetists were recruited into a randomised trial in which each performed nasotracheal intubation with all laryngoscopes, in both scenarios. The main endpoint was intubation time. Additional endpoints included laryngoscopic view, intubation success, number of optimisation manoeuvres, audible dental clicks and the force applied to the upper airway. RESULTS: Intubation time was significantly shorter using the McGrath MAC in both scenarios and using the Airtraq in the difficult scenario, when compared with the Macintosh laryngoscope. Both devices gave more Cormack and Lehane grade 1 or 2 views than the Macintosh in the difficult scenario (p < 0.001). The McGrath MAC had the best first-attempt success rate (98.4% vs. 96.8% and 95.8%, p < 0.001 for the Airtraq NT and Macintosh laryngoscopes respectively). The number of optimisation manoeuvres, audible dental clicks and subjective assessment of the degree of force applied were significantly lower for indirect laryngoscopes versus the Macintosh laryngoscope (p < 0.001). CONCLUSION: In a manikin, the Airtraq and the McGrath laryngoscopes appeared superior to the Macintosh laryngoscope when dealing with simulated airway scenarios. Both devices were associated with better views, intubation times and rates of success, especially in a simulated "difficult airway". Overall satisfaction was highest with the McGrath laryngoscope. Similar clinical studies are needed.
RESUMO OBJETIVO: Vários dispositivos podem ajudar a intubação nasotraqueal no manejo de via aérea difícil. Os laringoscópios McGrath MAC e Airtraq NT foram comparados com um laringoscópio Macintosh em estudo do desempenho de anestesistas com diferentes níveis de experiência, em manequim com cenário de via aérea fácil ou difícil. MÉTODOS: Foram recrutados 63 anestesistas para um estudo randômico, no qual cada um fez intubação nasotraqueal com todos os laringoscópios, em ambos os cenários. O desfecho primário foi o tempo de intubação. Desfechos adicionais incluíram vista laringoscópica, sucesso na intubação, número de manobras de aprimoramento, cliques dentais audíveis e força aplicada nas vias aéreas superiores. RESULTADOS: O tempo de intubação foi significativamente menor com o uso do laringoscópio McGrath MAC em ambos os cenários e com o uso do Airtraq no cenário difícil, em comparação com o laringoscópio Macintosh. Ambos os dispositivos obtiveram mais grau 1 ou 2 de Cormack e Lehane para visualização do que o Macintosh em cenário difícil (p < 0,001). O McGrath MAC teve a melhor taxa de sucesso na primeira tentativa (98,4% vs. 96,8% e 95,8%, p < 0,001, para os laringoscópios Airtraq NT e Macintosh, respectivamente). O número de manobras de aprimoramento, os cliques dentais audíveis e a avaliação subjetiva do grau de força aplicada foram significativamente menores para os laringoscópios indiretos versus o laringoscópio Macintosh (p < 0,001). CONCLUSÃO: Em um manequim, os laringoscópios Airtraq e McGrath pareceram superiores ao laringoscópio Macintosh para lidar com cenários das vias aéreas simuladas. Ambos os dispositivos foram associados a melhores visibilidades, tempos de intubação e taxas de sucesso, especialmente em simulação de "via aérea difícil". A satisfação geral foi maior com o laringoscópio McGrath. Estudos clínicos similares são necessários.
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Humanos , Masculino , Femenino , Adulto , Laringoscopios , Intubación Intratraqueal/instrumentación , Laringoscopía/instrumentación , Maniquíes , Factores de Tiempo , Estudios Cruzados , Diseño de Equipo , Intubación Intratraqueal/métodosRESUMEN
OBJECTIVE: Several devices can aid nasotracheal intubation when managing difficult airways. The McGrath MAC and Airtraq NT were compared with a Macintosh laryngoscope when studying the performance of anaesthetists with different levels of experience, in a manikin model of easy or difficult airway scenarios. METHODS: Sixty-three anaesthetists were recruited into a randomised trial in which each performed nasotracheal intubation with all laryngoscopes, in both scenarios. The main endpoint was intubation time. Additional endpoints included laryngoscopic view, intubation success, number of optimisation manoeuvres, audible dental clicks and the force applied to the upper airway. RESULTS: Intubation time was significantly shorter using the McGrath MAC in both scenarios and using the Airtraq in the difficult scenario, when compared with the Macintosh laryngoscope. Both devices gave more Cormack and Lehane grade 1 or 2 views than the Macintosh in the difficult scenario (p<0.001). The McGrath MAC had the best first-attempt success rate (98.4% vs. 96.8% and 95.8%, p<0.001 for the Airtraq NT and Macintosh laryngoscopes respectively). The number of optimisation manoeuvres, audible dental clicks and subjective assessment of the degree of force applied were significantly lower for indirect laryngoscopes versus the Macintosh laryngoscope (p<0.001). CONCLUSION: In a manikin, the Airtraq and the McGrath laryngoscopes appeared superior to the Macintosh laryngoscope when dealing with simulated airway scenarios. Both devices were associated with better views, intubation times and rates of success, especially in a simulated "difficult airway". Overall satisfaction was highest with the McGrath laryngoscope. Similar clinical studies are needed.
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Intubación Intratraqueal/instrumentación , Laringoscopios , Laringoscopía/instrumentación , Maniquíes , Adulto , Estudios Cruzados , Diseño de Equipo , Femenino , Humanos , Intubación Intratraqueal/métodos , Masculino , Factores de TiempoRESUMEN
OBJECTIVE: Several devices can aid nasotracheal intubation when managing difficult airways. The McGrath MAC and Airtraq NT were compared with a Macintosh laryngoscope when studying the performance of anaesthetists with different levels of experience, in a manikin model of easy or difficult airway scenarios. METHODS: Sixty-three anaesthetists were recruited into a randomised trial in which each performed nasotracheal intubation with all laryngoscopes, in both scenarios. The main endpoint was intubation time. Additional endpoints included laryngoscopic view, intubation success, number of optimisation manoeuvres, audible dental clicks and the force applied to the upper airway. RESULTS: Intubation time was significantly shorter using the McGrath MAC in both scenarios and using the Airtraq in the difficult scenario, when compared with the Macintosh laryngoscope. Both devices gave more Cormack and Lehane grade 1 or 2 views than the Macintosh in the difficult scenario (p<0.001). The McGrath MAC had the best first-attempt success rate (98.4% vs. 96.8% and 95.8%, p<0.001 for the Airtraq NT and Macintosh laryngoscopes respectively). The number of optimisation manoeuvres, audible dental clicks and subjective assessment of the degree of force applied were significantly lower for indirect laryngoscopes versus the Macintosh laryngoscope (p<0.001). CONCLUSION: In a manikin, the Airtraq and the McGrath laryngoscopes appeared superior to the Macintosh laryngoscope when dealing with simulated airway scenarios. Both devices were associated with better views, intubation times and rates of success, especially in a simulated "difficult airway". Overall satisfaction was highest with the McGrath laryngoscope. Similar clinical studies are needed.
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BACKGROUND: CMAC videolaryngoscope has recently been introduced for videoscope guided intubation. The aim of our study was to compare and evaluate the efficacy of the conventional blade and the angulated D blade of the CMAC videolaryngoscope with the direct laryngoscopes in simulated cervical spine injury patients on the airway manikin. MATERIALS AND METHODS: Following power analysis, 33 resident doctors were enrolled to perform endotracheal intubation using all the 4 different laryngoscopes namely the Macintosh laryngoscope, McCoy laryngoscope, conventional CMAC videolaryngoscope and the D blade of the CMAC videolaryngoscopes on the airway manikin in simulated cervical spine injury. The demographic variables of the resident doctors were recorded. The outcomes measured included vocal cord visualization (Cormack-Lehane grading), time taken to intubate, number of attempts for successful intubation and optimizing maneuvers required. RESULTS: The use of indirect videolaryngoscopes resulted in better glottic visualization in comparison to the direct laryngoscopes (CL-I) in 20/33 (60.6%) in the Macintosh group, 24/33 (72.7%) in McCoy group, 30/33 in (90.9%) in Vlc group and 32/33 (96.9%) in Vld group. The time taken to intubate averaged to 15.54±2.6 in Macintosh group, 18.90±4.47 in McCoy group, 20.21±7.9 in Vlc group and 27.42±9.09 in Vld group. The 1st attempt intubation success rate was 84.8% (Macintosh), 72.7% (McCoy), 90.9% (Vlc) and, 78.7% (Vld). CONCLUSIONS: The overall performance of the conventional CMAC blade proved to be the best when compared with the D-blade CMAC, Macintosh blade and the McCoy blade for intubation in simulated cervical spine patients by anesthesia residents.
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BACKGROUND: CMAC videolaryngoscope has recently been introduced for videoscope guided intubation. The aim of our study was to compare and evaluate the efficacy of the conventional blade and the angulated D blade of the CMAC videolaryngoscope with the direct laryngoscopes in simulated cervical spine injury patients on the airway manikin. MATERIALS AND METHODS: Following power analysis, 33 resident doctors were enrolled to perform endotracheal intubation using all the 4 different laryngoscopes namely the Macintosh laryngoscope, McCoy laryngoscope, conventional CMAC videolaryngoscope and the D blade of the CMAC videolaryngoscopes on the airway manikin in simulated cervical spine injury. The demographic variables of the resident doctors were recorded. The outcomes measured included vocal cord visualization (Cormack-Lehane grading), time taken to intubate, number of attempts for successful intubation and optimizing maneuvers required. RESULTS: The use of indirect videolaryngoscopes resulted in better glottic visualization in comparison to the direct laryngoscopes (CL-I) in 20/33 (60.6%) in the Macintosh group, 24/33 (72.7%) in McCoy group, 30/33 in (90.9%) in Vlc group and 32/33 (96.9%) in Vld group. The time taken to intubate averaged to 15.54±2.6 in Macintosh group, 18.90±4.47 in McCoy group, 20.21±7.9 in Vlc group and 27.42±9.09 in Vld group. The 1st attempt intubation success rate was 84.8% (Macintosh), 72.7% (McCoy), 90.9% (Vlc) and, 78.7% (Vld). CONCLUSIONS: The overall performance of the conventional CMAC blade proved to be the best when compared with the D-blade CMAC, Macintosh blade and the McCoy blade for intubation in simulated cervical spine patients by anesthesia residents.
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Anestesiología/educación , Laringoscopios , Laringoscopía/métodos , Columna Vertebral/cirugía , Adulto , Vértebras Cervicales , Humanos , Laringoscopía/instrumentación , Maniquíes , Factores de Tiempo , Grabación en Video , Adulto JovenRESUMEN
BACKGROUND: CMAC videolaryngoscope has recently been introduced for videoscope guided intubation. The aim of our study was to compare and evaluate the efficacy of the conventional blade and the angulated D blade of the CMAC videolaryngoscope with the direct laryngoscopes in simulated cervical spine injury patients on the airway manikin. MATERIALS AND METHODS: Following power analysis, 33 resident doctors were enrolled to perform endotracheal intubation using all the 4 different laryngoscopes namely the Macintosh laryngoscope, McCoy laryngoscope, conventional CMAC videolaryngoscope and the D blade of the CMAC videolaryngoscopes on the airway manikin in simulated cervical spine injury. The demographic variables of the resident doctors were recorded. The outcomes measured included vocal cord visualization (Cormack-Lehane grading), time taken to intubate, number of attempts for successful intubation and optimizing maneuvers required. RESULTS: The use of indirect videolaryngoscopes resulted in better glottic visualization in comparison to the direct laryngoscopes (CL-I) in 20/33 (60.6%) in the Macintosh group, 24/33 (72.7%) in McCoy group, 30/33 in (90.9%) in Vlc group and 32/33 (96.9%) in Vld group. The time taken to intubate averaged to 15.54 ± 2.6 in Macintosh group, 18.90 ± 4.47 in McCoy group, 20.21 ± 7.9 in Vlc group and 27.42 ± 9.09 in Vld group. The 1st attempt intubation success rate was 84.8% (Macintosh), 72.7% (McCoy), 90.9% (Vlc) and, 78.7% (Vld). CONCLUSIONS: The overall performance of the conventional CMAC blade proved to be the best when compared with the D-blade CMAC, Macintosh blade and the McCoy blade for intubation in simulated cervical spine patients by anesthesia residents. .
JUSTIFICATIVA E OBJETIVO: o videolaringoscópio C-MAC foi recentemente introduzido para orientar a intubação. O objetivo deste estudo foi comparar e avaliar a eficácia do laringoscópio C-MAC de lâmina convencional e C-MAC de lâmina angulada (D-blade) com laringoscópios diretos em simulação de pacientes com lesão de coluna cervical usando modelo de vias aéreas. MATERIAIS E MÉTODOS: após a análise do poder do estudo, 33 médicos residentes foram inscritos para realizar intubações endotraqueais, usando todos os quatro laringoscópios diferentes: laringoscópio Macintosh, laringoscópio McCoy, videolaringoscópios C-MAC convencional e C-MAC D-blade em modelos de vias aéreas com simulação de lesão da coluna cervical. As variáveis demográficas dos médicos residentes foram registradas. Os resultados avaliados incluíram visualização das pregas vocais (classificação de Cormack-Lehane), tempo necessário para intubar, número de tentativas para intubação bem-sucedida e manobras de otimização necessárias. RESULTADOS: o uso de laringoscópios indiretos resultou em melhor visualização da glote em comparação com os laringoscópios diretos (CL-I) em 20/33 (60,6%) no grupo Macintosh, 24/33 (72,7%) no grupo McCoy, 30/33 (90,9%) no grupo Vlc e 32/33 (96,9%) no grupo Vld. A média do tempo necessário para entubar foi de 15,54 ± 2,6 no grupo Macintosh, 18,90 ± 4,47 no grupo McCoy, 20.21 ± 7,9 no grupo Vlc e 27,42 ± 9,09 no grupo Vld. A taxa para a primeira tentativa de intubação bem-sucedida foi de 84,8% (Macintosh), 72,7% (McCoy), 90,9% (Vlc) e 78,7% (Vld). CONCLUSÃO: o desempenho geral da lâmina do C-MAC convencional mostrou ser melhor quando comparado com o das lâminas ...
JUSTIFICACIÓN Y OBJETIVO: el videolaringoscopio C-MAC fue recientemente introducido para orientar la intubación. El objetivo de este estudio fue comparar y evaluar la eficacia del laringoscopio C-MAC de lámina convencional y C-MAC de lámina angulada (D-blade) con laringoscopios directos en una simulación de pacientes con lesión de la columna cervical usando modelo de vías aéreas. MATERIALES Y MÉTODOS: después del análisis del poder del estudio, 33 médicos residentes fueron inscritos para realizar intubaciones endotraqueales, usando 4 laringoscopios diferentes: laringoscopio Macintosh, laringoscopio McCoy, videolaringoscopios C-MAC convencional (Vlc) y C-MAC D-blade (Vld) en modelos de vías aéreas con simulación de lesión de la columna cervical. Las variables demográficas de los médicos residentes fueron registradas. Los resultados evaluados incluyeron la visualización de las cuerdas vocales (clasificación de Cormack-Lehane), tiempo necesario para intubar, número de intentos para intubación exitosa y maniobras de optimización necesarias. RESULTADOS: el uso de laringoscopios indirectos trajo como resultado una mejor visualización de la glotis en comparación con los laringoscopios directos (CL-I) en 20/33 (60,6%) en el grupo Macintosh, 24/33 (72,7%) en el grupo McCoy, 30/33 (90,9%) en el grupo Vlc y 32/33 (96,9%) en el grupo Vld. El tiempo medio necesario para intubar fue de 15,54 ± 2,6 en el grupo Macintosh; 18,90 ± 4,47 en el grupo McCoy; 20,21 ± 7,9 en el grupo Vlc; y 27,42 ± 9,09 en el grupo Vld. La tasa para el primer intento de intubación exitoso fue de un 84,8% (Macintosh), un 72,7% (McCoy), un 90,9% (Vlc) y un 78,7% (Vld). CONCLUSIÓN: el rendimiento global de la lámina del C-MAC convencional mostró ser mejor cuando se le comparó con el de las láminas ...
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Adulto , Humanos , Adulto Joven , Anestesiología/educación , Laringoscopios , Laringoscopía/métodos , Columna Vertebral/cirugía , Vértebras Cervicales , Laringoscopía/instrumentación , Maniquíes , Factores de Tiempo , Grabación en VideoRESUMEN
The present study summarizes the current knowledge of the heat and cold stress which might significantly affect military activities and might also occur among travellers who are not well adapted to weather variations during their journey. The selection of the best clothing is a very important factor in preserving thermal comfort. Our experiences with thermal manikin are also represented in this paper.
El presente trabajo resume los conocimientos actuales sobre el calor y el estrés por frío, que puede afectar significativamente la preparación militar, y pueden también ocurrir entre viajeros no bien adaptados a los cambios de tiempo y temperatura durante su viaje. La selección de la ropa mejor y más adecuada es también un factor muy importante para evitar el calor y el estrés por frío, y mantener el confort térmico. Nuestras experiencias con maniquíes térmicos también aparecen en este documento.
Asunto(s)
Humanos , Ropa de Protección , Trastornos de Estrés por Calor/prevención & control , Hipotermia/prevención & control , Maniquíes , Frío/efectos adversos , Calor/efectos adversos , Hipotermia/etiologíaRESUMEN
INTRODUÇÃO: A literatura científica indica a possibilidade de a percepção da emoção e a formação da memória emocional serem discordantes entre jovens e idosos. A mesma é pobre ao explorar essa possibilidade. Neste estudo, relatamos os resultados obtidos em um experimento-piloto com uma amostra de idosos brasileiros, que classificaram subjetivamente, através da escala Self Assessment Manikin, imagens oriundas do International Affective Picture System. MÉTODO: Quarenta e oito idosos voluntários da Universidade Aberta da Terceira Idade, saudáveis clínica e cognitivamente, avaliaram o caráter alertante e a valência afetiva de 71 imagens do International Affective Picture System, aleatoriamente escolhidas. RESULTADOS: O grau de alerta reportado por idosos diante de um estímulo emocional é tanto maior quanto menor o prazer provocado por essa imagem-estímulo, resultando na existência de uma forte correlação negativa (r = 0,93) entre o grau de alerta e o estímulo desprazeroso. Em uma comparação do acima obtido com outro experimento normativo semelhante feito com jovens brasileiros e americanos, apontou-se para uma possível diferença cultural na forma de relatar subjetivamente um estímulo emocional. CONCLUSÕES: Os resultados obtidos com esta amostra estudada sugerem que pode existir uma diferença nos relatos afetivos entre os jovens e idosos, onde uma normatização do International Affective Picture System para uma amostra maior, representativa da população de idosos, seria útil para responder esta questão.
INTRODUCTION: The scientific literature points to a possible bias in the form perception and emotional memory are constructed when elderly and young individuals are compared. However, this possibility is underexplored. This paper presents the results obtained from a pilot study based on an elderly emotional subjective report after evaluation using the International Affective Picture System images and Self Assessment Manikin scale scores. METHOD: Forty-eight clinically and cognitively capable elderly volunteer subjects from the Third Age Open University evaluated 71 randomly chosen images of the International Affective Picture System in terms of arousal and affective valence. RESULTS: For the elderly, the greater the arousal, the smaller the pleasure resulting in a strong negative correlation (r = 0.93) observed between arousal and negative valence. A comparison with another similar normative experiment performed in young Brazilian and American individuals showed a possible cultural difference in subjective reports of emotional stimuli. CONCLUSIONS: This investigation indicates that there may be a difference between elderly and young individuals when affective reports of arousal are studied. A normalization of the International Affective Picture System for the elderly in a larger sample, representative of the population, might be useful to address this issue.
RESUMEN
OBJETIVO: Desenvolver e testar a similaridade de modelo de coluna lombar tipo manequim para treinamento de punção transpedicular em vertebroplastia percutânea. MATERIAIS E MÉTODOS: Foram confeccionadas 30 vértebras lombares à base, principalmente, de metacrilato, gesso e etil-vinil-acetato, a partir de molde de borracha baseado em vértebra humana. Os discos intervertebrais foram feitos com silicone para que houvesse similaridade anatômica e fusão de cinco vértebras. O segmento da coluna foi acondicionado no interior de um manequim coberto por tela de etil-vinil-acetato para que não fosse possível a visualização direta. Foi realizado curso teórico para seis especializandos de radiologia e neurorradiologia, que testaram o modelo para vários parâmetros de similaridade com a realidade, realizando 30 punções transpediculares, em três sessões de dez procedimentos por dia, com intervalo de uma semana entre cada sessão. RESULTADOS: Cada aluno realizou 30 punções transpediculares, porém oito punções foram desconsideradas, pois se observaram problemas de manufatura dos modelos durante estes procedimentos. Após a realização das punções, todos os participantes preencheram o formulário de similaridade, com 100 por cento de respostas positivas em relação à similaridade do modelo. CONCLUSÃO: Foi possível o desenvolvimento de modelo para punção transpedicular com similaridade satisfatória com o ser humano, configurando um instrumento de treinamento de vertebroplastia.
OBJECTIVE: To develop and test a model of the human lumbar vertebra for training transpedicular puncture in percutaneous vertebroplasty. MATERIALS AND METHODS: Thirty lumbar vertebra models were constructed from methacrylate, plaster and ethyl-vinyl-acetate, using a rubber mold of human vertebrae. The intervertebral discs were made of silicone to provide anatomical similarity and fusion of five vertebrae. This model of spinal column segment was positioned within a manikin with an ethyl-vinyl-acetate lining so that direct visualization was not possible. A theoretical course was given to six trainees in radiology and neuroradiology who have tested the models with respect to parameters of similarity with the reality, performing 30 transpedicular punctures in three series of ten punctures a day, with one-week interval between the series. RESULTS: Each student performed 30 transpedicular punctures; however, eight of these punctures were disregarded because of manufacturing defects of the dummies observed during the procedures. Similarity data forms were filled in by all of the trainees following the procedures, with 100 percent of positive answers as regards the models similarity with the human body. CONCLUSION: It was possible to develop a training model for transpedicular puncture with a satisfactory degree of similarity with the human body, constituting an appropriate tool for training in vertebroplasty.